Provider Demographics
NPI:1407576010
Name:TAIFOUR, MAYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:
Last Name:TAIFOUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2886 W DEVOY DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3981
Mailing Address - Country:US
Mailing Address - Phone:714-925-2537
Mailing Address - Fax:
Practice Address - Street 1:2886 W DEVOY DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3981
Practice Address - Country:US
Practice Address - Phone:714-925-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty